Rare diseases of epigenetic origin: Challenges and opportunities

Front Genet. 2023 Feb 6:14:1113086. doi: 10.3389/fgene.2023.1113086. eCollection 2023.

Abstract

Rare diseases (RDs), more than 80% of which have a genetic origin, collectively affect approximately 350 million people worldwide. Progress in next-generation sequencing technology has both greatly accelerated the pace of discovery of novel RDs and provided more accurate means for their diagnosis. RDs that are driven by altered epigenetic regulation with an underlying genetic basis are referred to as rare diseases of epigenetic origin (RDEOs). These diseases pose unique challenges in research, as they often show complex genetic and clinical heterogeneity arising from unknown gene-disease mechanisms. Furthermore, multiple other factors, including cell type and developmental time point, can confound attempts to deconvolute the pathophysiology of these disorders. These challenges are further exacerbated by factors that contribute to epigenetic variability and the difficulty of collecting sufficient participant numbers in human studies. However, new molecular and bioinformatics techniques will provide insight into how these disorders manifest over time. This review highlights recent studies addressing these challenges with innovative solutions. Further research will elucidate the mechanisms of action underlying unique RDEOs and facilitate the discovery of treatments and diagnostic biomarkers for screening, thereby improving health trajectories and clinical outcomes of affected patients.

Keywords: DNA methylation; bioinformatics analysis; chromatin remodeler; epigenetics; histone modification; rare disease.

Publication types

  • Review

Grants and funding

MK was supported by a grant from the Canadian Institutes of Health Research [EGM-141897] and is the Edwin S.H. Leong UBC Chair in Healthy Aging. ST was supported by grants from the Canadian Institutes of Health Research and BC Children’s Hospital Foundation. WG is supported by a BCCHRI IGAP award and CIHR Project Grant PJT-168982. SET holds a Tier one Canada Research Chair in Pediatric Precision Health and the Aubrey J. Tingle Professor of Pediatric Immunology.